Preschool parent-pediatrician consultations and predictive referral patterns for problematic behaviors.
OBJECTIVE
The present study examined parents' reports of the frequency, nature, and outcome of pediatrician consultation and interventions about significant preschool behavior problems.


METHODS
Parents were asked whether they consulted with their pediatric providers about disruptive behavioral problems during a longitudinal study of preschool children.


RESULTS
Eighty 4-year-old children had parents who had consulted with their pediatricians versus 90 children whose parents did not. Children who eventually met criteria for attention-deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) 2 years later, received different pediatric interventions at age 4 years than children who did not have a diagnosis, chi (2) = 9.28, based on parent report. Eighty-nine percent of children who were referred for evaluation or treatment by pediatricians later met criteria for ADHD or ODD. However, 56% of children who later met criteria for ADHD or ODD were not referred by age 4 years.


CONCLUSIONS
Pediatricians were able to differentiate between preschool children with transient versus persistent behavioral problems significantly better than chance, though a large number of children with behavioral problems were not provided with early assistance or referrals. Additional research is needed to obtain data directly from pediatricians about their interventions and resources for this vulnerable population.
Fanton
John H
JH
Department of Psychiatry, Baystate Medical Center, Springfield, MA, USA. john.fanton@bhs.org
MacDonald
Brittany
B
Harvey
Elizabeth A
EA
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000628:therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis* / Q000628:therapy; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000628:therapy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D010372:Pediatrics; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation